Laboratory markers of cardiovascular risk in pediatric SLE: the APPLE baseline cohort

被引：37

作者：

Ardoin, S. P. ^{[1
]}

Schanberg, L. E. ^{[2
]}

Sandborg, C. ^{[3
]}

Yow, E. ^{[2
]}

Barnhart, H. X. ^{[2
]}

Mieszkalski, K. L. ^{[2
]}

Ilowite, N. T. ^{[4
]}

von Scheven, E. ^{[5
]}

Eberhard, A. ^{[6
]}

Levy, D. M. ^{[7
]}

Kimura, Y. ^{[8
]}

Silverman, E. ^{[9
]}

Bowyer, S. L. ^{[10
]}

Punaro, L. ^{[11
]}

Singer, N. G. ^{[12
]}

Sherry, D. D. ^{[13
]}

McCurdy, D. ^{[14
]}

Klein-Gitelman, M. ^{[15
]}

Wallace, C. ^{[16
]}

Silver, R. ^{[17
]}

Wagner-Weiner, L. ^{[18
]}

Higgins, G. C. ^{[1
]}

Brunner, H. I. ^{[19
]}

Jung, L. K. ^{[20
]}

Imundo, L. ^{[7
]}

Soep, J. B. ^{[21
]}

Reed, A. M. ^{[22
]}

机构：

[1] Ohio State Univ, Med Ctr, Columbus, OH 43210 USA

[2] Duke Univ, Med Ctr, Durham, NC USA

[3] Stanford Univ, Sch Med, Palo Alto, CA 94304 USA

[4] Albert Einstein Coll Med, Bronx, NY 10467 USA

[5] Univ Calif San Francisco, San Francisco, CA 94143 USA

[6] Schneider Childrens Hosp, New Hyde Pk, NY USA

[7] Columbia Univ, Med Ctr, New York, NY USA

[8] Hackensack Univ Med Ctr, Hackensack, NJ USA

[9] Toronto Hosp Sick Children, Toronto, ON, Canada

[10] Indiana Univ, Sch Med, Indianapolis, IN USA

[11] Texas Scottish Rite Hosp Children, Dallas, TX 75219 USA

[12] Univ Hosp Case Med Ctr, Cleveland, OH USA

[13] Childrens Hosp Philadelphia, Philadelphia, PA 19104 USA

[14] Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA

[15] Northwestern Univ, Feinberg Sch Med, Chicago, IL 60611 USA

[16] Seattle Childrens Hosp, Seattle, WA USA

[17] Med Univ S Carolina, Charleston, SC 29425 USA

[18] Univ Chicago, Chicago, IL 60637 USA

[19] Cincinnati Childrens Hosp Med Ctr, Cincinnati, OH USA

[20] Childrens Natl Med Ctr, Washington, DC 20010 USA

[21] Childrens Hosp, Denver, CO 80218 USA

[22] Mayo Clin, Rochester, MN USA

来源：

LUPUS | 2010年 / 19卷 / 11期

关键词：

atherosclerosis; cardiovascular; lipid; pediatric; SLE; systemic lupus erythematosus; C-REACTIVE PROTEIN; SYSTEMIC-LUPUS-ERYTHEMATOSUS; DISEASE-ACTIVITY; ENDOTHELIAL FUNCTION; YOUNG-ADULTS; FOLIC-ACID; HOMOCYSTEINE; CHILDREN; DYSLIPOPROTEINEMIA; LIPOPROTEIN;

D O I：

10.1177/0961203310373937

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

As part of the Atherosclerosis Prevention in Pediatric Lupus Erythematosus (APPLE) Trial, a prospective multicenter cohort of 221 children and adolescents with systemic lupus erythematosus (SLE) (mean age 15.7 years, 83% female) underwent baseline measurement of markers of cardiovascular risk, including fasting levels of high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TG), lipoprotein A (Lpa), homocysteine and high-sensitivity C-reactive protein (hs-CRP). A cross-sectional analysis of the baseline laboratory values and clinical characteristics of this cohort was performed. Univariable relationships between the cardiovascular markers of interest and clinical variables were assessed, followed by multivariable linear regression modeling. Mean levels of LDL, HDL, Lpa, TG, hs-CRP and homocysteine were in the normal or borderline ranges. In multivariable analysis, increased Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), prednisone dose, and hypertension (HTN) were independently associated with higher LDL levels. Higher hs-CRP and creatinine clearance were independently related to lower HDL levels. Higher body mass index (BMI), prednisone dose, and homocysteine levels were independently associated with higher TG levels. Only Hispanic or non-White status predicted higher Lpa levels. Proteinuria, higher TG and lower creatinine clearance were independently associated with higher homocysteine levels, while use of multivitamin with folate predicted lower homocysteine levels. Higher BMI, lower HDL, and longer SLE disease duration, but not SLEDAI, were independently associated with higher hs-CRP levels. The R-2 for these models ranged from 7% to 23%. SLE disease activity as measured by the SLEDAI was associated only with higher LDL levels and not with hs-CRP. Markers of renal injury (HTN, proteinuria, and creatinine clearance) were independently associated with levels of LDL, HDL, and homocysteine, highlighting the importance of renal status in the cardiovascular health of children and adolescents with SLE. Future longitudinal analysis of the APPLE cohort is needed to further examine these relationships. Lupus (2010) 19, 1315-1325.

引用

页码：1315 / 1325

页数：11

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